How much rates vary
Facilitymedian $1,950 · 10th to 90th $955 to $5,888Professionalmedian $589 · 10th to 90th $437 to $912
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $7,762.47 | Facility | None | $588.84 | $2,137.96 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $776.25 | Professional | None | $398.11 | $501.19 | $776.25 |
BCBS Illinois Setting Facility Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $5,888.44 | Facility | None | $1,288.25 | $2,041.74 | $5,888.44 |
BCBS Illinois Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $758.58 | Professional | None | $478.63 | $691.83 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,584.89 Typical High $2,511.89 | Facility | None | $776.25 | $1,584.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $776.25 | Professional | None | $467.74 | $575.44 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,905.46 | Professional | None | $446.68 | $707.95 | $1,905.46 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $616.60 | Professional | None | $512.86 | $562.34 | $616.60 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,047.13 | $2,454.71 | $5,888.44 |
United Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $1,023.29 | Professional | None | $457.09 | $630.96 | $1,023.29 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $50.12 | $50.12 |
Where Illinois sits
The same service costs 5.4 times more in Oklahoma than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
OK $7,144MT $1,321
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.